Although ED visits for children declined significantly as the COVID-19-pandemic evolved, previous reports have highlighted disparate rates of visits for injured children during the pandemic.
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What new information is contained in this article?
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We found that pediatric trauma activations did not differ during the COVID-19 pandemic, but types and severity of injuries varied between pre-pandemic and pandemic periods.
Abstract
Background/purpose
We aimed to describe the epidemiology of trauma activations and variations in injury patterns, injury severity, and hospital length-of-stay for injured children in Los Angeles (LA) County during the coronavirus-disease-19 (COVID-19) pandemic.
Methods
We conducted a retrospective cross-sectional study of children aged < 18-years evaluated in 15 trauma centers from 2019 to 2020 and entered in the LA County trauma registry. We defined 01/01/2019–03/18/2020 as pre-pandemic and 03/19/2020–12/31/2020 as the pandemic period. Our primary outcome was pediatric trauma activations. We analyzed demographic and clinical data, including types and severity of injuries sustained. We conducted unadjusted bivariate analyzes of injury patterns between periods. Segmented linear regression models were used to test rates (per 100,000 LA County children) of trauma activations pre-pandemic versus the pandemic period.
Results
We studied 4399 children with trauma activations, 2695 of which occurred pre-pandemic and 1701 in the pandemic period. Motor vehicle collisions, gunshot wounds, and burns increased during the pandemic (all p-values< 0.05), while sports injuries decreased (p < 0.001). Median injury severity scores (p = 0.323) and Glasgow Coma Scales (p = 0.558) did not differ between periods, however mortality (p = 0.023) decreased during the pandemic. Segmented linear regression estimates demonstrated that rates of trauma activations pre-pandemic were similar to the pandemic period (p = 0.384).
Conclusion
Pediatric trauma activations in LA County did not significantly differ during the COVID-19 pandemic, but types and severity of injuries varied between pre-pandemic and pandemic periods. With lockdown restrictions being lifted and novel SARS-CoV-2 variants circulating, our investigation describes this recent epidemiologic phenomenon to aid future preparation for healthcare systems.
Level of evidence
Level III
Type of study
Retrospective cross-sectional study
Keywords
Pediatric trauma
COVID-19 pandemic
Abbreviations
ACS
American College of Surgeons
AIS
Abbreviated Injury Scale
CDC
Centers for Disease Control and Prevention
CI
Confidence Interval
CT
Computed Tomography
COVID-19
Coronavirus Disease-2019
ED
Emergency Department
GCS
glasgow coma scale
ICU
Intensive Care Unit
ICD-10
International Classification of Disease Version 10
IQR
Interquartile Range
ITS
Interrupted Time Series
LA
Los Angeles
LOS
Length of Stay
MPH
Miles Per Hour
MVC
Motor Vehicle Collisions
OR
Odds Ratio
SARS-CoV-2
Severe Acute Respiratory Syndrome Coronavirus 2
STROBE
Strengthening the Reporting of Observational Studies in Epidemiology
TEMIS
Trauma and Emergency Medicine Information System
WHO
World Health Organization
Cited by (0)
Previous communication: Podium presentation in the Scientific Abstract Session at the 2021 Western Pediatric Trauma Conference.